[]

i_l
i r

t:]
D
f_l
n
tl
tl A. trrrinorn
D Acla\ah iarinurn rnrl2pi Et st luru rln tLlDu
tl Fulnusinur:
E . rnt\induno\ orqln -iciruan U: 1t2m
[] indun
n . mont?\tn\d?n' Et saHrcst, rctt,, en ab<o
[] ai mornbnn scmipcrmca
tl t
cnr\rut u2n0 dttlpl9t dt)aut mrnl2dl :
[] 2plEln \Ulf [upun L7lLrllqrn
D 0n0ql tuDun me,E \um
->
t_l c, 0 roan Lubuh-> I turn
t:] -s sfru\4LurnUl
tnqV(1n Der-02s1fk2n
t-l a. EprLel oioi tprh, nUKtUii PUll en0rh Eal
t_l Epttr,\ si\indris Ib*tnq, nukltuE i d;Err Ecl )
E r , E pibo\ \nubut L bunf uk kubus, nu tus 8. brs?f
t:]
[]
t_l B lrdrslrhrn 9E111-11-191 , Ctt r rnmt2
[] E nitu
t:] isrn ?n (2n0rl nDfi.
t:] )u ll tlil , 0sm0s1 s , Dsi , 8r
tl reEl .

tl ln LDrt'lrurn :

"''ffiB
I+d!.w{d;rJ
 t:] ?pl\cr dlr?h , EL\T
[] us l? tlLt , otnllt/ &,
t---l
L] itc\ oipi crl2pts anul
tl -'?Dltann trsuEun s l
L] r?P21.
t:] Funosinur s0D10t\
t:] -[e,rc\e
|?nn0ln
t:] Ro ; rnulul, ro
t:] ?Kt, c{2n vl
n
tl

t_l Bcr asarlrtn l2Pls2n tlflllU2,r rnenll

t:] 1
4l . ibol sihndris !
n H rnur sc\zpis silin
n un0Etnu2 st02 nutnst r uEus
[] 2n ErKrcsl .

D Tercl: I t)n TUIII :

D K e\enur @lnl2n. ton ?nus ,

t_l LmpLdu ,

[] EP silin 2Dlg
[f 10lE2n 1 D2nUl
t:] Funusi ) (eD2ilil un() & sL rest
D Terclap: Llrum :
tl L:rin r) r kt lcnt:r
[]
t:]
D scl2
t:] xD\s2nnr)l I,l)
tl
n I seb:tJ:i &.s resl
*ffEffiqnrel
F*aW€E
w

I
t:] Te,r zY cli izn tum :
t_l Fo\i 0ulflum, ,rmu 12n ouarium, cELis,
D rninu: 2n kctrnter ,nn il
tl r lnu\i
D
E lDl(ln I D?nu2
tI F unusin I ECD1Clil 1 ndu 1n 8. Ptn
n upf,s2n , 2 s0r?st & ECKrrSl
n
.

Ter tfln0ln
D Lrmu lln 0u2 nuin Lrf\E, tns2 rnl
D n{,tr0n \nll , KClf,n\2f
t:]
t:] rn si si
n .T
i Eusun ole, :pis -
[] ?rLnt DrE? Dtru0l
[] 1n D rmu Tepii r nn\,F
t_l . Ttr ilr,liurn
'
t:] I,l , url f 2, salurran 29)n , crnlh
t_l
D
D . X rrinurn ,f2n a2 lrn
[] suKrutt scn lN? un mrm u prOsf,t tsl0l0
t:] Kelcnt;rn l1
D ). tn00
D l0t2K 2 E2\Unn
1 uEus
D Con mu\t, 2 rLu\ , \r0l ,&
D tiroid
D b. EEo
D 2 E2lunn u(us
D Con 2h, krnn tn\^rtrs , &
D trornOn.
*6ffi1
tg.-€$fl
\s.--"a#,
t l
L]
tl tn m t,rn xnn
t_l
t_l . Tem mm lffipan cn
tl . Sir u\rsi
[] f,:ri an ini ersusun
[] rlriks
t_l Te,rrJiri rri brbmri scral, ffiis: lil, ul:Elin,
t_l dan r ufL[, gLtv) 2n1n - b2 1n ct?s2r rnlsrln
D Ir)m rnu \iqrk tri a k
t(?rn r2\ur0nl
D b. Se,l - so\ usun
t:] S e,l \rn 2W2r2
f_l
t_l L> roV'lin
tl Ssl lem;
rl L) rnt,nUtm
t:] rgml
E Lv mCrn qr 2nlt
[] Mr
[] E(,\nUl DCrUnrn - u , mcrnl
E rnq2n, Ell rnlfi, u
f:l rnref ce,ll)
tl > ELt-g(, anc.l m(,m
r] 2nn : tnu Ko ul eR u2n 2n
tl HisLrmin , ,rrnt2 \f2s ?12
[f
tl Tr
t:] HisLlm\n meru 7n 72
tl ssl tt2n0 [rrh]
t:]
*m
 Nlo.

Date:

n e. ^Irri
.
D Ter 1n rn:Lri mrn rndun
D ultr, ?(fin.
tl ' gd - sr\nut iaranq, dari gol rn:\lro[]L\ , ( lsm?,
L] 2N EL 12n
n D:lam mrLri 2nt
tl sedt\t\ iLrmu
tl m enu0Ko 2nm
tl 2n l2n lnt i2rnl lln.
tl
rl
[] Ut, (2lUI-2t'\ LNLLEN2)N,
fl ?nrl , ?l,tEon 9Af2L,K
t:]
t-t 1n
1-l iclorn\nrgi o\ch effif" kohclt,n I Lldrk allslis)
ll MaLriksnur mcmi\ikr Ecrll ulr crhirnnlLan
E Mrrn on g(,bea;\ iem LILR)L7N
n t
Etrf tl02mm unluk prrsrn ltn.
LI 2nlrn or0ln - oroln fuDu
D 10\\ men\2
D I rri lnl
fl >\\ 2m tn
n
E(.

Jrnn ln ik:
tl mpun is:n (,rrnis
t_l
t_l
D
[t
E
tl
 Date:

[] ln lem: A
n ersuEun d1fl sLl - scl lcrn rcul4 rnrm
tl strll,/ rnrfriks.
t_l Khusurs unfuk mr,nirnbun rntnulm
L_l Fu stnul :

tl 1nt2l?n unfuk rndindu | }ra)

t_l Pcrscdiun L2dannn ffii 2n1n
[t lfur ELt

D Te,r ) t nurris s{,luru : di btwth kuli

n (LI'(I It ilncli:n,
l2r1
dan st tL2t orq2n - or4ln drlarn
tl
tl Irrinorn nw2n ar
tl . 'Tergusurn dari ?nln lElr u2
tl muKord .

[]
lt
ffi Eil tut2no r2ilJln Krnclrosi
1d2 2ntK3 lUlanc r:wtn Lcr
L] mf,senvilm , ?ac\t ortn LWze t(,rhLn
[] )nq n(^Jtn t nI40nduum
[]
tl Tutanll ra$en [ ?ltn
[] . tjerwlrnl nuLi ruln,. 12nEplDn, r elx[t-
[] gi[rs rr?2nLllK 2r2m luDuh,
clt )
[:] l\\
[] Embrro I ilmcmlu
[] Peunsr [f,n, Lllu
tI El\utln
[:] Tulanq r:rum-Elx
tl . Tersusun dzri s
E

LllS n wlml unt

[:] )u) : f,rn 10, tnn , hidu , &l2un
t:] ts,
[]
*ffi,
t_l
D . Tarsugun 6l2n seh ,n, ptrw2rnl
ft ur\, llrl Dwan forku
tl 2n tn lrl rult - ru2s ul2n
tl
tl
t:] L. 1nn0ln
t_l . Tctgugun ?n Ecl-sc u0sl
tl trDLnf u 2n jeL(fi
n Senurwr usunnul Ctjlz, Cz?}q, M
tl Ba Llz , BeSOa
tt tln a"siri )
Aet.but' Si Lrn ,H :ucrs " i
tl lptEln Konscn ris mtLriks ur orcliri
[:] 2nm fnlnt,D en g) cl:n 0l?0m
tl ruanu \tu\ dl lntlrl \2tnil2 ?nm ]n-
D
L-t rnr\\ E2.L\nn U2 rHun st rnrnu)\ur
D m)K?nln 2n mLn u?rK2n z Els2.
[] Sr\utrn hrue,rg : 2nn d?n sl
tl i mcnr:c\i ,

tl r Trl?n0 Vorts 0mP? tl: rn

n 2n P2 ,nn
L] ulznq EPons \0s1/ ilr m
t:] Onuql , 0Dt1
f_l
tl 1n
t_l ' Torsu(un c\ari (el - sc 2n fnl s cllr
tl
t:] l.
Itrotrt
-

ln ttt r0m
n ?9ml il?
t.l Fun trtlj2 Slfl - s2fl ml lnrn, 02,
rc
{"1,
&t
L
t_l sisl"m rsmr, 2nm
tl rosl 1r1 mcr
t:] en[ut'(nu] pl14on
[] TidrL< bcrin[t s

E M e.nLl:ndur unLu z& Cjt

rl crlKotr 1r1
t:] emi\iki inlt E

il Trdrx mcn02nctu
tl Un(lEt : elS[ 01fl lnln
D Dibtui munirdi :

[] 6ranul usi
L] L> rnemili[ri n 0r2 i sfl
n C ont,o I ' Ncu ostn , B:Eo
D r?nut0sl
t:] idrk memtliki dn or2null di EiLo tsmrn
tl C onf ct &. Monos
t_l
[] . \rerDLnlux tcm
tl mcmrtrkr
t_l FuinClsi : rn umbrn
[] 1Kl0? erustk2n
t:] lgrnf d1rl
t:] 10t2n t2lr 2 a2Y)
[] M enr,trnriun tsrnl lruttn
D it, gortr ln r,[n lnln, f0m
[] rmon )
[-J Tur iri c\:rt :

E A\bumin
tl . O\obu\in
E
E
*F.€ffi#l
EH,lu*E-l
$tl!i'#
 No

Date

t:] g. 2nn01n
-t'lrsurEun
t_l rri . gcrr ulLt-,90t -q tm[ 061

D rn1l,{rof 2
t_l . -lordror 2 ordln mus, 0nEi
t:] lirur.
t-l 0 rnd urunu" tr\(cl0m ana dise ul us
n ilnu1 :
cDll1n uDun, fit0n0ln uL iarinrtln
tl err rn rninuti , trmlk, d:n
n :in l
drn sl[ttrn 2nnoln m(,
L] gisLfrn
D
[] C. trerinqln
n . Ttrqusutn drn sol -
. A\rf grr:k tkttl
s

[]
t:] , O(,rlV bt,itacli l,<trlnr rnc lntsmr ontnKE\ scrl
tl onLnt<fi cr0tn i:n A ?n miosin )
n 0m 2n Rn0ntl
il
D
n -
.
B crbtnfu EmLril t,lm
tl lnt\ se rns
t_l tK lLlS cmlu2n
[] . hJr ) i2m1
t_l . Rt,1 Et l 1( nn0gln 2m
[] Terd? lndrn0 0 uD2n , miErln
t:] LMDUITI )t2 , LlSLlS, 1-2

t:]
t:]
[] Bcr cntL\ si\rn
t_l salu i
f_l e :ksin\"1: L(,
*ffi
tV.SJ-q
t]#
 Date:

f:l Mr rbri (,rsu(un 2mt s ) mcm n-

tl 'MTl
tl tsl ann
[] ) rln
t:]
tl
t_l Mirt
D ECI EltU
[:] znLll ,rur mmLrus
t:] ilcmu r rnlun i
t_l
tl D..f,ari
L] Funqlsi ' rnu^l0lai\l 2n stn - ErnLll c Erturu
t:] Tersuruln d:n sel - e nruron,
D Neuron dibe,drkln mcn
[] . N(,uron sengori
t_l M enOrrirn\ntn sinut )n m"Lnurtu sar
t_l pusll
t:] Nlc,ttTon," m
tl en0urmkln sinu:L :c,hrri Elrlt Dugt mtndru l2n
[] ]ln.
t_l 'ntsrf nturon tr/:ps/ ct/arl rintpst! un/u, '//7n sl
t_l I e,chnuhtn scbu tT s ncuron ludift dxi :

t_l ). Denc\ril ': xrnl u1n0 mcm illIl 2Eml

t:] l{-\lrLl L1ad)n (d & :kson
tl tn sc l2n su Ear:1 gtnQ m"cn
D tut 6( nuk\00us
t:] LLIN /A r0n :,, DefllUtUt[l]'t pl?Sm] lng ffirrnbrr,ur
[] nnil sln ulr rn-Tc,l
t:] E(,tu rnLl(,iln
t:] -+ nauri lrmr
*ml
sc\ul
 t:]
f:l
E
t:]
D
t:]
n
D
[] A clel; LOLTAD) 0r0r lnl ElEt
[] ll2m BerdrErr rn lcYt ), 0Yu2n iba
D rnrn\l
D .
I Orqrn clr\rm , usus",:
[] 0 ro?n lurr uliL, mtb:, unq, ie
n ?nq?n ,

D b ebunpr conLo 242 hrutn :

tl
D 1. dlntun
D . Mt,rnom 2r) r scturun tuDu
t_l Turd\fl d:n : rn 2n 1n
t_l ?n ierin 2n sl
D
t:] rU- zru
tl rrnlPxln
E Ttrrltn ?n r?r7
[t
t_l xl1
n trf1n
tl T srdiri trtr ln slrl
t_l
n
tl
aaffi
-it{5.d*5.3€]
'#

I
 D
t_l nt{,rn1tn*
tl TLrgurgutn d1r4. r . 11T1n03ff
t_l
tl
t:]
fl . IV\ (,N ln ntun 2l)rn uDu
tl Te,rqugun : l2tltl0?tl nul
[] 1nn01n s?
t:]
D .Tclinur
tl . A\: mn & IrCsCtrnbrn0)n
D Tr$uqun , i1n
i:l n01n t
D
D
D n02ilr2n guhur
D Tgrsutun rlrrt ; l1rin0an otot, .t1fin01n
.C 1n t?r
D
t:]
t:]
D
t_l
t_l
t:]
[]
D
L]
[f
t_l
*ffi-ffi]
 D
D
{. ) ,.

tl

tl
t_l
L J.-,.
tl \cleh rbunutn orttrn ln mil tKuKln f,f1 ,LI
--.-..
LJ 1\lm SisLm or 2n )
I'n2nuil] i m t/l|
;
tl -

[] s 1n
tl F unosi
1

[] Vl umbon bonLu
n .
indunur oro tn 2n0 \unl
t:] lv1 irnprn cadan ln mtn[2
il ' Tum rntu ln sel - set d;lt
tl FN
----
)
[] rn 1n 1 ), lnq rusuk, Luiln4 bthu,
t:] u\ln n U\ , u\lno r,kgfrcrnibts 2hs
t:] 7n ?W7 , lrn 0rl
[]
E 9ist,urn
L] Funusinur '.

[] M umbtn Lr 1K2n uDu

L] ur iu
[] 0nu\ cn
t:] 0ir rln ), &
[]
t_l
tt
*m
I
D c. Sistcm Pcncorn?tn 4."

[] u\nqttnul :

[] (,nrlrnt & rnmu Lrl qln - slfl m) lnln strln mrm2n-

[] l]\,K2nnul lllm oscs Sistologis si trn 0r01n.
t_l TLrsuqun :lrE : tt\\l\U f0nqk0nq?n , tmDu , UtUS
rl 2\L\S, usus Dcglrl al:n 1nut.
tl
tl D. Sis tm Pcrnr 2Sln
n Fun Eil1ut :

il enu2m 0z ln mm ulr ln L)z

D 2n 0n rbo\isme.
[] Tcrsusun roK?n, f2l"<e),
fl hn US, \rron cc|lus, 8L Itt i
L]
t:] E. SisLrm Trrns .tit /' Pareol:r:n Drr
r_l 0z ]n s;fl-s)n ml lnzn
t_l
tl r0gt ln st(e rYt \sm0
D un0\
t:] TgrEusun r u\u 2t)
[]
t:] . Sis -Sr
tl Funltsinur :

[:] Lnrr\ml xn rn0n2n

D uDun dzn ln
D Terrugun drri '
, Surn(um til1 ln0, 2 2t)
tl Eln Elr (ilm6um
E tllKrn
tl
E
n
*ml
w
t_l
tl Funosin
[] Mrm lnKln v0\2 UE tt\ts m
[] PtrK{,m 1K7n .

D {,'Janibr : 0\l2flum, u Lrut, 0u\ , &. vtuin:

t:] L!U\S, V]E 0lcren(, lmtE, illL
n H.
[] istcm E
t_l FunuginU: :

[] tmDl0rlu m0n lrn sir

t:] rnot:Vo\\Emu
t:] TerEusun o\L Ln\2r n[1roi
[] cn\1r ipogste , : ten & V,L lillln ,
tl
n cst { vtnru,lu)nn
n
E cnrlu\ulrrk;n Eisr - EiEl lndt ismr
t:] t\uK2n 0
tl enl)0r Vosumbrnurn c,rinn
D omcoshsis)
[] Tcr lr\ ltls : hll\r 0lltlll\ , 14Utl
D
[j
D
tl
tt
tl
E
tl
[]
tl
*m